The aim of this article is to discuss the diagnostic approach of an increased serum PTH concentration in a normocalcemic, normophosphatemicpatient. Detection of this biological presentation is frequent in ... [more ▼]

The aim of this article is to discuss the diagnostic approach of an increased serum PTH concentration in a normocalcemic, normophosphatemicpatient. Detection of this biological presentation is frequent in routine practice all the more that PTH reference values established in vitamin Dreplete subjects with a normal renal function are used by the clinical laboratories. The first step in this diagnostic approach will be to rule out acause of secondary hyperparathyroidism (SHPT). Among these, the most frequent are vitamin D deficiency, very low calcium intake, impairedrenal function, malabsorptions, drugs interfering with calcium/bone metabolism, such as lithium salts and antiresorptive osteoporosis therapies,hypercalciuria due to a renal calcium leak. If no cause of SHPT are evidenced, the diagnosis of normocalcemic primary hyperparathyroidism(PHPT) should be considered. A calcium load test is a very useful tool for this diagnosis if it shows that serum PTH is not sufficiently decreasedwhen calcemia rises frankly above the upper normal limit. In a normocalcemic patient with hypercalciuria and a high serum PTH concentration,a thiazide challenge test may help to differentiate SHPT due to a renal calcium leak from normocalcemic PHPT. Beyond the discussion of thisdiagnostic [less ▲]

A finite word u is said to be bordered if u has a proper prefix which is also a suffix of u, and unbordered otherwise. Ehrenfeucht and Silberger proved that an infinite word is purely periodic if and only ... [more ▼]

A finite word u is said to be bordered if u has a proper prefix which is also a suffix of u, and unbordered otherwise. Ehrenfeucht and Silberger proved that an infinite word is purely periodic if and only if it contains only finitely many unbordered factors. We are interested in abelian and weak abelian analogues of this result; namely, we investigate the following question(s): Let w be an infinite word such that all sufficiently long factors are (weakly) abelian bordered; is w (weakly) abelian periodic? In the process we answer a question of Avgustinovich et al. concerning the abelian critical factorization theorem. [less ▲]

The term ‘phytoestrogen’ is used to define a wide variety of nonsteroidal compounds that occur naturally in many plants. When they are absorbed by cows, these polyphenolic compounds undergo ... [more ▼]

The term ‘phytoestrogen’ is used to define a wide variety of nonsteroidal compounds that occur naturally in many plants. When they are absorbed by cows, these polyphenolic compounds undergo biotransformation by specific bacteria present in the gastrointestinal tract. The resulting metabolites are absorbed in the organism and some are excreted in milk. The impact of these compounds on human health divides opinion. Some scientists believe that they might have adverse health effects. Others believe the opposite, especially with regard to their microbial metabolites, such as equol. Whatever one's view on the subject, scientists need accurate, sensitive and rapid analytical methods in order to continue the research on clarifying the phytoestrogen issue. Cow's milk is an animal product that is common in the human diet, and it is therefore important to evaluate its content of phytoestrogen metabolites. In order to study the human intake of equol via commercial milk, an analytical method was developed and validated following EMA/CVMP/VICH/463202/2009 guidelines. Enzymatic hydrolysis was used to release the equol. It was then extracted using double liquid/liquid extraction and analyzed using UPLC®-MS/MS, with an analysis runtime of only 5 min. This analytical method produced a linear calibration curve with a high correlation coefficient (R2≥0.996) between 5 and 1,000 ng mL−1. Good intra- and inter-day precision (RSDs≤5.3% and ≤5.2%, respectively) and accuracy (bias≤8.6%) were achieved. The recovery rate differed slightly among the different types of milk, ranging between 60.6±1.09% and 82.3±5.21%. Good method repeatability was observed (RSDs<15%). There was neither a matrix effect nor a carry-over effect, and the sample extracts were stable during storage for at least 7 days at −21°C and 5°C. In order to apply the proposed method and obtain an initial estimate of equol concentration in cow’s milk in Belgium, 44 samples of various brands found in several supermarkets and 5 raw milk samples from Walloon farms were analyzed. Equol was found in all the samples analyzed, with a concentration ranging from 10 to 50 ng mL−1 for conventional milk and from 70 to 130 ng mL−1 for organic milk. These results were compared with other European studies and the same trend was observed. The results obtained show the specificity, sensitivity and precision of this method for analyzing oestrogenic metabolite-equol in cow’s milk. This study should be extended to include a greater number of samples and be implemented over a longer period to see if there is a correlation between livestock practice and/or sample origins with the equol content in milk. The addition of other phytoestrogen compounds with this method, using UPLC®-MS/MS technology, could also lead to more reliable monitoring of these compounds in dairy production. [less ▲]

Immunosenescence as complex modifications of immunity with age could be related to the so-called frailty syndrome of elderly leading to an inadequate response to minimal aggression. Functional decline ... [more ▼]

Immunosenescence as complex modifications of immunity with age could be related to the so-called frailty syndrome of elderly leading to an inadequate response to minimal aggression. Functional decline, the loss of ability to perform activities of daily living, is related to the decrease in physiological reserves and frailty and is a frequent outcome of hospitalization in older patients. Links between immunosenescence and frailty were explored and 20 immunological parameters were affected in seniors with functional decline. IGF-1, thymopoeisis and telomere length were part of these markers. A strong relationship between insulin-like growth factor-1 (IGF-1) and thymic ouput was evidenced. IGF-1, mediator of GH, was subsequently shown to induce IL-7 secretion in cultured primary human thymic epithelial cells (TECs). We are also exploring the ‘stress hypothesis’ according which an acute stress is the discriminator revealing a frailty susceptility. GH can counteract the deleterious immunosuppressive effect of stress-induced steroids. Under non-stressing conditions, the immunosenescent system preserves physiological responses, while in stressing conditions, the combination of immunosenescence and a defect in somatotrope axis might lead to functional decline. [less ▲]

Background Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug–related problems (DRPs ... [more ▼]

Background Community pharmacists have an important task in the follow-up of patients treated with antithrombotics. When delivering these medicines, pharmacists can encounter drug–related problems (DRPs) with substantial clinical and economic impact. Objective To investigate the amount and type of antithrombotic related DRPs as well as how community pharmacists handled these DRPs. Setting Belgian community pharmacies. Methods MSc pharmacy students of six Belgian universities collected data about all DRPs encountered by a pharmacist during ten half days of their pharmacy internship. Data were registered about DRPs detected at delivery and in an a posteriori setting, when consulting the medical history of the patient. Classification of the DRP, cause of the DRP, intervention and result of the intervention were registered. Main outcome measure Amount and type of antotrombitocs related DRPs occurring in community pharmacies, as well as how community pharmacists handled these DRPs. Results 3.1 % of the 15,952 registered DRPs concerned antithrombotics. 79.3 % of these DRPs were detected at delivery and 20.7 % were detected a posteriori. Most antithrombotic-related DRPs concerned problems with the choice of the drug (mainly because of drug–drug interactions) or concerned logistic problems. Almost 80 % of the antithrombotic-related DRPs were followed by an intervention of the pharmacist, mainly at the patient’s level, resulting in 90.1 % of these DRPs partially or totally solved. Conclusion Different DRPs with antithrombotic medication occurred in Belgian community pharmacies. About 20 % was detected in an a posteriori setting, showing the benefit of medication review. Many of the encountered DRPs were of technical nature (60.7 %). These DRPs were time-consuming for the pharmacist to resolve and should be prevented. Most of the DRPs could be solved, demonstrating the added value of the community pharmacist as first line healthcare provider. [less ▲]

Incident reporting is usually considered as an effective means to improve the safety of “at risk” socio-technical systems (e.g. nuclear plants, large industrial facilities, hospitals), as it allows ... [more ▼]

Incident reporting is usually considered as an effective means to improve the safety of “at risk” socio-technical systems (e.g. nuclear plants, large industrial facilities, hospitals), as it allows implicated actors to learn from past incidents. Safety could thus be enhanced via the use of an institutionalized Incident Reporting System (IRS), enabling organizations to improve the quality of actions and reactions in case of a deviation from normality, or to prevent such deviations from happening in the first place. Yet, there is a lack of inductive analyses of actual, on-site uses of IRS. In this paper, we address this gap, using the results of 28 semi-structured interviews conducted with agents from the Belgian Nuclear Research Center (SCK•CEN). The study relies on a vulnerability-oriented Science and Technology Studies (STS) approach. Our results show that practices of incident reporting are more varied than the institutionalized ones. Indeed, actual reporting practices are to be related to specific expressions of solidarity between colleagues within a negotiated drift – a pragmatic interpretation of the reporting procedure. These results are discussed in a vulnerability-oriented perspective. Overall, the paper displays a grounded analysis of incident reporting practices which may contribute to a better understanding of how safety is co-constructed by workers, and provides opportunities for further research and concrete path of actions for practitioners. [less ▲]